The relationship of emotion regulation and attachment styles in adolescents diagnosed with major depressive disorder

Aim: To compare emotion regulation and attachment styles between a patient groups aged 12-18 years, diagnosed with major depressive disorder (MDD), and a healthy control group. Methods: 51 MDD patients, and 51 age-matched healthy control participants made up the study sample. A child psychiatrist applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) on each of the research participants. The following scales were also applied to all the patients and control subjects: the Children’s Depression Inventory (CDI), the Adolescent Friendship Attachment Scale (AFAS), and the Difficulties in Emotion Regulation Scale (DERS). Results: The CDI total points, the AFAS avoidance attachment, anxious/ambivalent attachment subscale points, and the DERS total and subscale points were found to be statistically significantly higher in the MDD group than in the control group. The AFAS secure attachment subscale points were found to be statistically significantly higher in the control group than in the MDD group. A statistically significant positive correlation was determined between the CDI total points and the DERS goals, impulse control, awareness, strategy, clarity and the DERS total points, and between the AFAS anxious/ambivalent attachment and the DERS total points. A statistically significant negative correlation was determined between the AFAS secure attachment subscale points and the DERS acceptance subscale points. The avoidance attachment style points and the DERS total points may be highly predictive of MDD, according to the results of the logistic regression analysis. Conclusions: The study's findings showed that the avoidance attachment, anxious/ambivalent attachment, and difficulty in emotion regulation scores were higher in adolescents diagnosed with MDD than in control subjects. These findings showed that the severity of depression in adolescents with MDD is significantly correlated with difficulty in emotion regulation. The study's findings also point to avoidance attachment style and difficulty in emotion regulation as potential risk factors for MDD.